Provider Demographics
NPI:1639432875
Name:UNIVERSITY OF FLORIDA
Entity Type:Organization
Organization Name:UNIVERSITY OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:FAY
Authorized Official - Last Name:BALKCOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-265-0680
Mailing Address - Street 1:1600 SW ARCHER RD
Mailing Address - Street 2:UF DEPARTMENT OF PATHOLOGY
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0275
Mailing Address - Country:US
Mailing Address - Phone:443-629-9410
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:UF DEPARTMENT OF PATHOLOGY
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0275
Practice Address - Country:US
Practice Address - Phone:443-629-9410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN17429281P00000X, 282N00000X, 286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
No282N00000XHospitalsGeneral Acute Care Hospital
No286500000XHospitalsMilitary Hospital